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Shoes: Anatomy, Types, and SelectionAndrew BernhardKent State University College of Podiatric MedicineSt. Joseph Medical Center – Houston, TX
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Shoe History• Shoes have been around
since at least 7500 BCE• Otzi the Iceman died
around 3300 BCE with shoes on
• Romans wore sandals similar to todays around the beginning of the common era.
• Modern shoes, with sewn-on soles, have been produced since the 17th century
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General Shoe Anatomy
• This is the modern athletic shoe.• It’s composed of three major parts,
with variable components for each.
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Dress or Casual Shoes
• Male Shoes• Oxfords or Balmorals• Derbys or Bluchers•Monk Shoe• Slip-On Shoes
• Female Shoes• High Heels•Mules• Slingbacks• Ballet Flats
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Boots• Very common
footwear, especially down here.
• They extend up the leg and can be for men or women.
• Types:•Work boots• Cowboy boots• Hiking boots• Snow boots• Dress boots
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Other Common Types
• These do not really fit into any major category
• They are currently very common in the US, though• Clogs• Sandals• Boat Shoes• Slippers
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Athletic Shoes• These shoes stand to
offer the best in fit, comfort, and control
• Can sometimes not be worn due to restrictions at work or in social situations
• Can be easily modified with orthotic inserts
• Are designed to be sport-specific
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What type of shoe should you be in?• Determined by an
individuals needs, including level of activity, appearance, and pathologies present.
• Some need more control while others need more support.
• Most people will do best in an athletic shoe, from the podiatry aspect.
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Shoe Selection Criteria• Shoes should be fit on two
basic considerations: arch type and motion available
• Arch types include rectus, pes cavus, or pes planus
• Motions are generally described in regards to the subtalar joint:• Overpronators, Pronators,
and Underpronators
• There are three basic shoe constructs for these foot types:• Motion control, Stability, and
Cushioned shoes
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Motion Control Shoes
• These shoes are best for patients with pes planus, those who overpronate, and those who are overweight.
• The shoes are more stable, rigid, and are bulkier.
• They may offer a medial post to provide suppor along the arch.
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Stability Shoes• These are best for a
“normal” foot; a rectus foot that pronates normally.
• The shoe is moderately rigid, especially at toe-off, with adequate cushioning.
• It is not designed to control motion or provide cushioning, but simply walk the line.
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Cushioned shoes• These shoes are
probably the least used; a small percent of the population has a cavus foot.
• With a lack of pronation, there is more force on the plantar lateral foot.
• These shoes tend to have flexible outsoles and extensive shock absorption.
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What can evaluating shoes tell you?
• By checking wear patterns, we can accurately and easily determine a patients gait pattern.
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The Importance of Shoe Selection • Selecting the perfect
shoe may not be important for everyone.
• Patients presenting to a podiatry clinic, however, will have benefit from proper shoegear.
• Diabetes, arthritis, plantar fasciitis, and fat pad atrophy are just some conditions that highlight the need for specific shoes.
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Thank You
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References• Cheskin MP, Sherkin KJ, Bates BT. The Complete Handbook of Athletic
Footwear. Fairchild Publications. 1987. • Dutra T. “Chapter 3: Athletic Foot Types and Deformities” Athletic
Footwear and Orthoses in Sports Medicine. Werd MB, Knight EL (eds.). Springer Science and Business, 2010: 37-46.
• Frederick EC. “Physiological and ergonomics factors in running shoe design” Applied Ergonomics. 1984. Vol 15 (4): 281-287.
• Gould N. “Shoes and Shoe Modification” Disorders of the Foot. Jahss MH Ed. Saunders. 1982: 1745-1782.
• McPoil TG. “Athletic footwear: Design, performance and selection issues” Journal of Science and Medicine in Sport. 2000. Vol 3 (3): 260-267.
• Smith LS. “Athletic Footwear” Clinics in Podiatric Medicine and Surgery. 1986. Vol 3 (4): 637-647.
• Subotnick SI, King C, Vartivarian M, Klaisri C. “Chapter 1: Evolution of Athletic Footwear” Athletic Footwear and Orthoses in Sports Medicine. Werd MB, Knight EL (eds.). Springer Science and Business, 2010: 3-17.
• Yamashita MH. “Evaluation and Selection of Shoe Wear and Orthoses for the Runner” Physical Medicine and Rehabilitation Clinics. 2005. Vol 16: 801-829.